What does low PAPP-A and high hCG levels indicate?

Question

Hi doctor,

My wife has done a PAPP-A screen test and results are 1.9 and hCG level 65.6. She is 12 weeks pregnant. Please advise regarding the same. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

You need to attach the complete report issued by the laboratory. Important thing is the graph and the MoM (multiple of the median) values which have been calculated as per the gestational age. The risk is calculated accordingly. In case of Down's syndrome, there is low PAPP-A (pregnancy-associated plasma protein A) levels and high hCG (human chorionic gonadotropin) levels which is what it looks like with the information provided. So please upload the scanned report completely for better review.

Answer 2

Hello,

Welcome back to icliniq.com.

As suspected there is a high risk for trisomy 21 or Down's syndrome in the fetus as per the reports (attachments removed to protect patient identity). Next best way to confirm or rule it out would be to perform karyotyping of fetal cells obtained through amniocentesis procedure by 13-15 weeks of gestation. So, please opt for it and if the karyotyping by FISH (fluorescence in situ hybridization) indicates trisomy then it shall confirm that the fetus is Down's syndrome and then the decision shall be yours to continue or terminate before 20 weeks.